My journey as a neurodiverse student nurse with Rochelle Tattersall

Let's Talk Nursing with Rochelle Tattersall.

In this episode, Samina is joined by Rochelle Tattersall, a recent nursing graduate from the University of Leeds, now working as a registered community staff nurse at Mid Yorkshire Teaching NHS Trust. They discuss Rochelle’s journey of navigating her autism diagnosis while studying as a student nurse.

Throughout the episode, they explore a variety of topics, including:

• Getting an autism diagnosis
• Stereotypes that autistic nurses and student nurses encounter
• Requesting reasonable adjustments at university and on placement

Hear Rochelle’s three key actions for neurodiverse student nurses when going on placement, neurotypical nurses when interacting with neurodiverse colleagues or students and all nurses when facing challenges in their roles. Listen to the end to hear Rochelle’s practical tips for requesting reasonable adjustments and handling difficult situations as part of our scenario-based reflective exercises.

About Rochelle:

Rochelle Tattersall recently graduated from the University of Leeds, and is now working as a registered community staff nurse at Mid Yorkshire Teaching NHS Trust. Her passion for nursing and writing drove Rochelle to become a Nursing Times Student Editor, where she discussed what it’s like to be an autistic student nurse – she is now an outspoken campaigner for the rights of autistic nurses and students.  Her love of writing also drove her to write her first novel and become a published author, while studying.

Contact Rochelle:

LinkedIn: linkedin.com/in/rochelle-tattersall  

More information and resources:

Rochelle’s article about being a neurodiverse student nurse: ‘I can still be a nurse while being neurodivergent’

Supporting the needs of neurodivergent nurses in the workforce

Supporting patients with autism: part one

Supporting patients with autism: part two

BJN inform:

For more information and resources, go to: https://www.bjninform.com/lets-talk-nursing-podcast/ 

New to the platform? BJN inform is a mentor-in-your pocket digital resource for nurses, nurse associates and nursing students, providing you with easy-access articles on topics across clinical areas, person-centred care, career and nurse wellbeing.

If you would like to speak with us about a no-commitment demo or trial, please get in touch at: institutions@markallengroup.com 

Transcript

Let's Talk Nursing is brought to you by BJNinform.com, a learning platform for bite-sized evidence-based content that supports all aspects of nursing. I'm Samina Hashimi, editor of BJN inform, and in each episode I chat with experts about topics across person-centred care, nurse, wellbeing and career development. Together, we'll explore their experiences and discuss practical tips and insights that you can apply to your nursing practice.  

Hello and welcome to this My Wellbeing episode of Let's Talk Nursing, the BJN inform podcast. Today I'm joined by Rachelle Tattersall, who is a student nurse, soon to be registered nurse, at the University of Leeds. Her passion for nursing and writing drove Rochelle to become a Nursing Times student editor, where she discussed what it's like to be an autistic student nurse. She's now an outspoken campaigner for the rights of autistic nurses and students. Thank you so much for joining me, Rochelle.  

That's okay.  

And congratulations on being as soon to be registered nurse. When does that officially start? 

So I'm got two shifts left on placement and then just got to go to exam board so... 

Ohh, that's amazing and yeah, I just I hope it goes really well.  

Thank you.  

So in today's episode we’re looking at Rochelle's experiences of being a student nurse while navigating her autism diagnosis. We'll explore topics around getting a diagnosis, being on placements, reasonable adjustments, and general intersectionality between autism and nursing. So before we dive into the episode, I wanted to do a quick terminology check. I'm aware that many people prefer autistic person over person with autism. But obviously this can depend on who you're talking to, so I just wanted to double check this with you. What are your preferences around terminology when talking about autism? 

 I think autistic person probably sits better. I'm not that attached to any terminology really, but I think yeah, autistic person is probably better. 

Yeah, that’s the way to go. Yeah. Okay. Amazing. Thank you for clarifying that. I'll stick to autistic person, autistic student nurse and soon to be nurse. 

Yes. So you've written about receiving an autism diagnosis later in life and how this affected your self-perception. Could you tell me a bit about your journey towards being diagnosed?  

So yeah. I was diagnosed about just coming up three years ago, and I went for diagnosis because I recognised a lot of myself in my son who is autistic, and it took quite a long time and it's not an easy thing to get. You've got a lot of hoops to jump through. Especially, well I was going to say, especially as an older person, but I think even when you're trying to get a diagnosis for a child, it's still quite difficult. But now I've got it, I am really, really happy that I went for it and it did sort of change my perception a little bit and for a little bit I was a little bit like questioning everything in my life, but now I'm really grateful that that I did do it. And I had to pay for it privately. I couldn't... It wasn't something that was available to me through the NHS, but I am glad that I did it now and that I've got it because it's really helped me in the last few years. 

Yeah. And when you say that you saw signs in yourself that you were seeing in your son, what sort of signs were those? 

Perfection is a big one for me and the need for routine, like quite strictly adhering to routine, preferring to be or needing to be on my own quite a bit to sort of recharge after I've been with other people. And like I mask quite a lot. So I... and I see him doing that. And then when he comes home, it's like the mask comes off and it's like, he just... he lets his real self out. And I think I do that. I do a lot of that as well. And it's just like little things from you know, preferring your own company to needing that time to reset after you've been around other people. There was just lots of quite little things that I had thought about, but not really thought about in that much depth until I noticed it in my son. And then I I started to think maybe there is. Maybe that is why I've struggled so much. Maybe I'm autistic as well. And yeah, that's kind of what started the ball rolling for me. 

I'm sure most nurses are aware, but just for those who maybe are a bit unfamiliar, could you explain what masking means? 

So it's putting on a front when you're around other people to try and look ‘normal’. So because I didn't know I've done it my entire life, I sort of reigned myself in quite a lot. So... and try my best to fit in, so I will mimic other people, their behaviours, even things like making eye contact, I find it's so difficult, but I will do it because I know that that's kind of what you're supposed to do. So it's... Yeah. It's like acting like you think you're supposed to act. When really inside you're screaming saying, ‘Oh my God this is so difficult’. I think that's the best way I can explain it.  Does that make sense? 

Yeah, no, definitely, that makes a lot of sense. And like you said, you feel like when you're out in public, you're putting on a front. And then when you get home or in your private space and suddenly that mask comes off. And you feel like, yeah, you can let your true self go, and with your son as well. 

Yeah. 

And after you received this diagnosis, how did you feel, and how did this affect your life, if at all? 

At first, I felt like my entire life had been a lie. I was quite upset, and it makes you reevaluate. I reevaluated so many things about my my childhood, like my entire life. But then afterwards, it was just like this profound sense of relief. Like it explained so much of how I felt about things and how much I struggle with like social interactions and how like the lengths that I've gone to try and be like everybody else and fit in and be bubbly. And I remember once when I was quite a bit younger, I worked part time in a hotel as a hotel reception, and I had like a one to one with the manager and she was like, you don't smile enough. And I'm like, that's not who I am. And I felt like there was something wrong with me because of that, but genuinely I'm just not a smiley person. I'm not and I find it really difficult to fake it. And all that stuff started to make sense and and then it's like I say, it was just, it was just a relief to be able to say, ‘there's not something wrong with me. I'm just an autistic person and that's how my brain works, and that's who I am’. Yeah, that's... It was like a process. It was like a letting go of who you think you are and then just embracing how I actually am. That's probably the best way I could explain it. 

Yeah, definitely. It can also almost be a form of validation. 

Yeah. Yeah, that's yeah. 

All those difficulties you had and people told you didn't smile enough. Which, by the way, is a bit of an awkward comment anyway. But yeah, then sort of just knowing that there's a reason for that and being able to, I don’t know... justify might be the wrong word, but kind of explain it to yourself if anything. 

Yeah. 

And before recording this episode, we chatted a bit about, you know, the negative stereotypes around being an autistic person and especially being an autistic person who's pursuing a career in nursing. Have you personally encountered any stereotyping, and if so, could you tell me a bit about those experiences? 

Oh yeah, you get comments like either ‘you don't look like an autistic person’. Okay, what does an autistic person look like, or ‘how are you going to do that? How are you going to be a nurse as an autistic person?’ Because there's this stereotype that autistic people can't empathise with other people, and empathy and compassion are such a big part of nursing. 

I think that is probably one of the most dangerous stereotypes around being autistic. But like the... you don't look like an autistic person is... I get that quite a lot. I wouldn't know that from looking at you. Okay, do you want me to have a big sign on my head? A fellow student said... I was talking one day about how when I've been... when I've done like 2 long days on shift, I need a day at home in bed on my own, like not communicating with anybody to recover from that. And it was like, ‘well, how are you going to work on the wards then? If that's, you know, your response to be able to do that’. And I was like, I felt a little bit like that was used against me, but also that they just assumed that I wouldn't be able to do it because I'm autistic. Yeah, unfortunately there is still quite a bit of that out there. 

And like you said, that is a really dangerous assumption. Just thinking all autistic people don't have empathy, so they can't be nurses. Yeah, yeah. And before we started recording, you also said something really interesting, that a lot of people meet one autistic person and then say, yeah, I know what all autistic people are like. 

Yeah, yeah. 

You know, this one person is a representative of the entire community and how incorrect that is. 

Yeah, yeah, I think  it was Chris Packham that I heard say it. When you've met one autistic person, you've met exactly one autistic person, and it really stuck it really stuck with me. And that... whenever I come up against somebody saying something like that is kind of what I will put back out there and I will say, you know that it doesn't define me and my personality. I'm as different from any other autistic person as you are from any other person that's not autistic. So. Yeah. 

Exactly. There's diversity in every community. You really can't put people in a box like that. No. And this is a bit of a tangent, maybe, but I've heard that a loss of autistic women in particular experience those kinds of comments that you mentioned of, ‘Oh I wouldn't have known that you're autistic’ or ‘you don't look autistic’, and do you feel like that has played a role in how people interact with you and your diagnosis? 

Yeah, I think so. I think women can take masking a step further because we can literally put a mask on. We can do our hair, we can put makeup on. Not that men can't do that, but generally speaking, men don't do that so I don't know. It's like there is a presumption that an autistic person is going to look a certain way and when we don't like a certain way because we put makeup on and we do our hair and we dress up and all that sort of thing, then people think that we're not, we're not all autistic, what they think. And I do think it is more significant for women, because appearance tends to be a bigger thing for women. You know, a little bit of a tangent there, but yeah, that I think it goes hand in hand with that. 

No, that definitely makes sense. There's sort of the character trait masks and then also like you said, the physical masks, like you can actually change your appearance. Not that there is one way that an autistic person should look. 

No, no, but yeah, I think unfortunately when people hear autism, they think of one end of the spectrum that quite often comes hand in hand with other difficulties, learning disabilities and things like that. And they expect you to have got a sign written across your head to say ‘I'm autistic’, but they don't think of the other end of the spectrum, where people have jobs and children and families and for all intents and purposes, live this normal, whatever normal is, life. And they can't sort of marry the two things up in their heads, if that makes sense. And again, that comes back down to stereotyping. 

Definitely. And aside from stereotyping, how has autism affected your time studying nursing at university and being on placements? 

I think... I've been to university before. And I didn't really think that the diagnosis would impact me one way or the other. I think the difference being is going on to placement... new environments I find quite difficult. So whether that's going on to another new placement area or starting a new job, I do find change in new environments quite difficult. So, it's definitely impacted that, but having the diagnosis has helped me to be able to approach people in a different way and explain what I need. And I've got sort of a learning plan in place for both in placement and actually in university. And it’s helped me understand like... I get quite frustrated in lectures when people around me are talking and chattering and I can hear them and it's really, really distracting. It's helped me understand that and it's helped me do something about that and I will generally ping an e-mail off to the lecture and say, ‘can you tell people to be quiet, please, because I’m really struggling’. So it's impacted me quite positively, I think and that it's helped me to get the best out of being at university and the the best out of my placements and stand up for what I need. Because I think previously, I wouldn't necessarily have said anything. I wouldn't have stood up and and asked for what I need and it's given me that push to be able to do that. So I think it's been a really positive impact for me. 

Yeah. And you mentioned sort of emailing your professor and being like, ‘this is very disruptive to my academic environment, can we change this?’ Around that, what were some reasonable adjustments that you requested at university and, you know, were there any reasonable adjustments that you requested on placement as well? 

Yeah. So in terms of actually being at university, when you have seminars and things like that, I sometimes need to take myself out of the room. It can get quite noisy. There's a lot of group activities. I'm not the biggest fan of organised fun so I find group activity quite stressful really. So like just saying I just need 5 minutes out of this or being able to just take a step back from the group activities sometimes and people being aware of that it's not that I want to be disruptive or I don't want to join in or I think that it's below me or anything like. That it's just being able to do what I need to do to get through the day. Because getting into university, I find quite stressful. Generally I have to use the train and then walk through the city and so it all kind of piles up a little bit sometimes. So I've been able to have adjustments around, just taking some time out is mainly the thing that I asked for. And then on placement I have a plan in place that is agreed with my academic assessor and my practice assessor and practice supervisors on placement and it's things like making sure they allow me the time to go in and have a look round before I actually start. The anticipation of starting and the the unknown make that first day quite difficult for me anyway, and asking for wherever possible plans to stay as they were planned. It's not always possible, particularly in a hospital, things change really, really quickly. But generally if I'm assigned to a certain team, keep me there, because otherwise that kind of sends my entire day into a nowball before we've even started and I start catastrophising things. I think they're the main things that I ask for, but I do have like a written plan for when I'm on placement as to what needs to happen. So the meeting beforehand to let people know that I'm autistic to say what I need from people, to let them know that sometimes I might be a little bit withdrawn. It's not that I'm not interested, it's that I'm overwhelmed. And to be able to take that time out somewhere quiet when I need it. 

And what have your experiences around requesting reasonable adjustments been like, you know has, has it been really difficult to push this or have people been helpful? 

No, not really. Predominantly, it's been really positive. There's been a couple of occasions where it's maybe not been as positive, but because I have these things written down, when they don't happen I can then go back to to the university, to my practice assessor, to the educational team actually within the trust and and say these things aren't being met and then I've got, you know, a little bit of back up to either get things sorted or on one occasion I've moved placements because I found it, it just wasn't getting changed. But having that back up, having that plan in place and those reasonable adjustments has allowed me to do that. So... But generally it's been really, really positive and everyone's been really nice about it. There's been a lot of understanding, but I think you need to be proactive is the thing there. Like when I first started and I had just been diagnosed, I wasn't as proactive as I necessarily should have been and it led to not a great experience. So I learned from that and I've been much more proactive since and like I say, generally speaking, 90% of the time it's worked really well. 

And you mentioned adjustments not being met and then having to change placements. Could you talk a bit more about what happened there? 

Yeah, I mean it, it started out, it was... So it's this most recent placement that I've been on. So it's my management placement. It's a really important one. You've got a lot of stuff to learn and it was not great from the initial contact with the placement area. And that I said, you know, I'm autistic, this is what I need, can I come in? And my requests were just ignored right from the start, which didn't go down great, so I already went in with this and then when I actually got there. I was moved around all the time. I was... There was... My practice assessor worked predominantly like 3 weeks of nights out of a month, so I didn't really get to work with one person. I was put here, there and everywhere which I found really really stressful and then when it came to having to raise a concern, my concerns were brushed off and that like sort of sets me on this spiral of thinking that like I don't... I don't really know how to explain it. It just sets me on this spiral of thinking like I can't do it and it makes it really difficult for me to show up and go in. And then I was expected to do things that I felt like I shouldn't have been expected to do. But I've got nobody that I could raise those concerns to. They weren't giving me the time that I needed. It was quite a stressful environment. It was a really, really busy ward and there were... there was never the opportunity for me to take any time out anywhere. And I just got to a point where I thought I just, I'm not getting anywhere on my own here. So then I had to go back to the university and say look, these are my adjustments, this is what's happening, this hasn't been met. And they were... the university were really good at dealing with that and then asked me what I wanted to do and I said I need to go somewhere else. I don't feel like this can be rectified here, and fortunately they moved me on the new ward that I'm on. It's been amazing there and, you know, it's just as busy, it's just as stressful, but it's been a really good experience, so I'm glad that I stood up for myself and and I'm glad that I had those things written down and in place. That meant that within about two days I was able to switch and my experience wasn't... I haven't had to extend by much. My placement and my experience wasn't interrupted. There wasn't a massive gap and things. So yeah, it's turned out quite positive, but it's not okay... 

Yeah, that sounds like a really difficult situation to have to deal with, but it sounds like you handled it really well and at least you're able to change placements and and you enjoyed the second placement. And you mentioned sometimes showing up to placement and being a little overwhelmed and this coming across as looking bored or like you don't want to be there, maybe. And in your Nursing Times article you wrote about an experience you had on your first placement, where your desire to be on the placement was questioned because of this. Could you talk a bit about this experience? 

Yeah, so it was my first ever placement. My first day. The only time I'd ever been on a hospital ward before that was when I was visiting somebody. So it was a really overwhelming day for me and I was working with a healthcare assistant just to get to know the the routines of the ward and you know do personal cares and things like that. That tends to happen on your first day on any placement just to get an idea of what's going on. But by sort of midday I was really, really overwhelmed and kind of just stood back in a corner like and obviously looked like a rabbit in the headlights and the healthcare assistant that I was working with approached me and said ‘I feel like you don't want to be here. You think that my job is below you’, and was quite intimidating, quite nasty, quite in my face about it. And I got, really... I was really, really upset. And I had to take myself away and walk off, walk off the ward. But it was so soon after I'd been diagnosed. I hadn't told anybody, like the university had said ‘it's entirely up to you. You don't have to tell people if you don't want to, it's whatever you're comfortable with’. So I hadn’t told anybody. I thought I'll be fine. I've lived for 30 odd years not knowing...  never had to say anything so I'll be fine. But then quite quickly, it became apparent that in this new situation, maybe I wouldn't be fine. So I did have... I did get my practice assessor and I explained what had happened and I said ‘I'm so sorry, I should have said something’ but again she was really, really good about it. And she was like, ‘no, that's your choice. Whether you say something or not, nobody should speak to you, speak to a student like that at any time but let alone on your first day of your first placement’. So, yeah, I Iearnt very quickly that that does have an impact and I probably do need to speak up. So I do tell people when I first start working with them, if I go a little bit quiet and if I'm a little bit withdrawn, I'm probably overwhelmed. Just give me a bit of space and that generally is what happens now. And the person that I was working with did apologise to me afterwards and said ‘I'm really sorry, I shouldn't have done that’, but they shouldn't have done that whether I was autistic or not, it was just that... It's just how I came across obviously wasn't what was expected of me. 

But yeah, it was. It was rectified again, but that was quite a stressful situation and quite difficult for me. So I think my learning out of that was to be quite open straight off the bat because then nobody has got anything to come back to you. 

No, thank you for sharing that. And yeah, again sounds really difficult, but I'm glad at least there was some kind of resolution at the end and I guess, I don’t know, this might be too positive minded, but at least there were sort of lessons learned and with future placements, similar things haven’t happened. 

Yeah, yeah, definitely. Yeah, particularly in nursing, it's all about lessons learned and you know, and knowing that sometimes things do go wrong, but what can we learn from that? So it turned what was quite a negative into something that's been quite positive for me for the rest of my journey through university. So yeah. 

Mm-hmm. Which is coming to a close as well. So moving on to our three key actions, this is where I ask our guests to outline 3 practical actions that nurses who are listening can take away from the episode and start implementing into their practice or their lives. This can obviously be recommendations for neurodiverse nurses or student nurses, but also neurotypical nurses who are maybe interacting with neurodiverse colleagues or patients and want to learn more about this. So what is the first key action that you would recommend? 

I think what I've said before about having these honest conversations is really, really important to the smooth running of everything and telling people what your needs are. Just do it. I think just being really open and upfront and it can be quite... It can feel quite awkward. But I think if everybody knows where they are and what page you're on before you even start, you've got a really good foundation to start with, and at the end of the day, you're a student and you are there to learn. And having these conversations before you even start will put you in a really good place to be able to get the most out of university and your placements. Yeah, I think that'd be my... That's my first. The first thing I would say to do is have these conversations with people. 

Definitely. And like you've outlined from your personal experiences, it's good to just rip off the band-aid and get it out with, and then it will help you in the long term, yeah. And what is your second recommendation? 

Yeah. So I think when... more for other people is to... when people, when if somebody does come up to you and and has these honest conversations with you, it's sort of trying to adjust to meet those needs, and I think an example of like I said earlier about when you get there and you've moved a team or something like that. Don't just throw that at somebody. That happened to me and I was like... they said, ‘Oh, you know can you move from this team to that team?’ It was in front of everybody in the middle of handover and I was like, I was really blindsided by it and I just kind of put a smile on my face and went ‘yeah, that's fine’. But really inside, I've got all this stuff going on and it really stressed me out and it made my entire morning really difficult. And afterwards, I said to to the person that said it, I said ook, I understand that things change and you know the needs of the ward might be different. But if that's gonna happen in future, just think about how you're gonna do that. Just pull me to one side, explain why you're doing it and say, you know, just a simple “I know this is what the plan was. We've had to change the plan because of this. Is that OK with you?” Give me 5 minutes to process it. That time to process is really important and I'll come round and I'll be fine.’ So it's just thinking about how you approach things. It's not, you know, just bending to the needs of one person. It's more thinking about how you approach that person because that makes a massive difference to how they receive it and to their entire day. If that that makes sense. 

Definitely. Yeah. I think even if you're not an expert on autism or neurodiversity in general. Just being considerate of people’s different needs and yeah, having those conversations around that. 

Yeah. Yeah. 

And what would be your third key action? 

I think this is probably for everybody. But it's just look after your mental health. It's really stressful being a student nurse, whether you're on placement or university, there's a lot to learn. You feel like there's a lot on your shoulders, and if you need that time out, taking it. Obviously, particularly if you are neurodiverse, it's probably... you probably need a little bit more of that, because especially if your placement is on a ward, it's a really artificial environment. It can be quite overwhelming and you can't look after anybody else if you're not looking after your own mental health. So taking that time that you need to take your breaks. Always take your breaks. There's no badge of honour for not taking it. But then if you need that extra time, if you need that 10 minutes, use it. You’re not superhuman, right? Because you might not get that opportunity again. So just look after yourself. And I generally need to sort of debrief at the end of the day. So, I... on my way home will generally speak to my mom and just let it all out and it's very... it's not, you know, debriefing about patients and going into detail. It's more about how I felt throughout the day and just getting that all out and then being able to get home and start afresh the next day. But I, like I said, that's probably for everybody, not just... I don't think that that just applies if you’re neurodivergent. I think. I think that's probably advice for everybody. 

Yeah, I think we talked about this in another podcast episode where the guest said there's only one of you, and if the nurse isn't taking care of themselves, then ultimately that's going to affect the patient as well. And so, it's almost part of your role of being a nurse to do that self-care, to take care of your own wellbeing because that will help your practice. 

Yeah, and mistakes happen when you don't, so when you're not looking after yourself, mistakes happen, and then everybody suffers. So I think, yeah, it's huge for everybody. Not just for being your neurodivergent, but I think particularly when you are, you really do need if you need 5 minutes, you need to take that 5 minutes. 

Yeah, a small step that makes a big difference. Yeah, definitely. Well, thank you so much for sharing those actions and giving our neurodiverse and neurotypical listeners, some concrete tips to, you know, really start implementing. 

Yeah. 

For the final segment of this episode, we're going to look at a couple of scenario-based reflective questions. So I'm going to read out two scenarios that a neurodiverse student nurse might encounter, and we'll then discuss how you would approach these situations. For our listeners, feel free to pause the episode and think about what you would do in these scenarios and then press play to hear Rochelle's approach. So our first scenario is you've been diagnosed with autism and want to request reasonable adjustments at your university and placements. How can you go about requesting this? So we've obviously discussed your personal experiences around requesting reasonable adjustments earlier in the episode, but what would be your step by step recommendations to another autistic student nurse who wants to request adjustments? 

So at my university, we have a disabilities team that are generally university wide. So my first step was to approach them. They looked at my report, I had a couple of meetings with them and they drafted reasonable adjustments document that then went to the School of Healthcare and then I had a meeting with the School of Healthcare to look specifically at my needs around the course that I was doing. It's obviously really different to a lot of the other university courses. So it needs tweaking. The disabilities team were great, but also the School of Healthcare have been really good as well and before I even step foot on placement, we've got this document in place so in writing. For what I would need when I was on placement and then you also get like extra time in exams. Which I didn't think I needed, but it turns out it's actually really helpful and I get to generally sit my exams away from the main group of people. So there might be 10 of us in a room instead of 150 of us, which again is really helpful when people are rustling papers and the things that I talked about that I find really distracting. You might, especially if it's a late diagnosis, might be a little bit reluctant to have those things because you think, well, I've never had those in the past, I don't need them now. But it will make your journey through university much easier, if you do have those adjustments in place. The exam thing for me, I didn't think was going to be an issue, and actually it made such a big difference. 

So it's just reaching out, finding out who are the people to support you in the first instance. So you've got to be just a little bit proactive. 

Yeah, yeah, I think that's really helpful. And yeah, it's interesting that you say, you know, being proactive, getting the adjustments in place, but then also not shying away from the adjustments and recognising that actually they can be super helpful. So the second scenario is you've asked for reasonable adjustments to be made at your placement and it has been agreed that these adjustments will be put in place. However, during your time at the placement, most of the requested adjustments were not made. How would you approach this situation? 

Yeah. So we did talk about this earlier about that is what is what happened. So in an ideal world, what you would do is speak to your practice supervisor, your practice assessor. 

Yeah. 

And you would hope that that would rectify the situation. You have that document for a reason. If that for whatever reason isn't working, the next step for us, I don't know about different trusts, but within our trust we have practice learning facilitators that are there to support students so then your next step is to go to the practice learning facilitator and say, ‘I've got these adjustments, these aren't being met’ and they would support you in having a meeting with your placement area to find out why they're not being met and what can be done to change. Then you also have sort of back up from the university in terms of your academic assessor. Unfortunately for me, none of those things really helped. And in the end, I went to my programme lead, who is a lovely lady and she's really approachable and she knows me quite well. So there are, there's always people that are willing to help. You've just again, you've got to be proactive and reach out and stand up for yourself. But in the first instance, just have these open conversations with your placement area. And if that then isn't working, there are plenty of other people that you can go to that will help. Yeah, but it's just... It's being proactive and reaching out to start off with I think. That... It's probably the most important step and then not backing down because it's quite...  Can be quite intimidating. These people have been generally people that you look up to that have been qualified for you know, a lot longer than you and you might want to think, ‘Oh I'm being you know, I'm overreacting and I should just get my head down and get on with it’. Because that's what these people are saying to do, but you've got to remember that it's your journey and your learning, so you've got to stand up for yourself. So whoever the person is in your trust, that is like our practice learning facilitator. So there will always be somebody that is there that works for the trust that is there to support students. So find out who they are. In fact, everybody should find out who they are the first day they go on placement, because they're really good at supporting you because they want you to succeed. So find out who that person is and then they're there when you need them. 

Yeah, it's really finding that point of support. Yeah. Yeah. And I think that's super helpful because I'm sure there's so many students who don't even think about needing that. 

Yeah, I'd never thought about needing the practice learning facilitator until this most recent placement and and then I realised I had no idea who that person was. And although when I spoke to her, she's like ‘Oh, there's a board up on the ward with my details and stuff on it’ When I actually got to the board, they'd covered it with a big trolley, so you couldn't see the board. 

Ohh no. 

But that's why I didn't know who she was. But just ask. Just ask your practice assessor. You know, as have it as part of your initial interview, who's practice learning facilitator or, you know, the person that is there to support students. Because there will always be somebody and find that point of contact and you know, perhaps if you are autistic or have any other learning needs, you've got ADHD, anything like that, reach out to that person straight away. As soon as I moved placements, the first thing I did was find out who the practice learning facilitator was for this new placement, and reached out to her. As it turned out, the other practice learning facilitator had also got in touch with her and said, ‘just want to make you aware of this student that's coming; and then she came to see me to make sure that everything was okay and, you know, that's what they're there for and it's been really helpful. 

Find that person. Yeah, and I think I mean, obviously you don't want anything to go wrong, but it's great to be proactive, find your point of contact so that if something does happen, then you immediately have that line of communication that you can rely on. Yeah. Amazing. Thank you so much. I really hope that gives practical insight for people who might find themselves in similar situations. So that brings this episode to an end. Thank you so much for joining me today, Rochelle, you've been an absolute pleasure to talk to. 

My pleasure. It's been lovely. 

If you enjoyed this episode of Let's Talk Nursing, do follow us for new episodes and share with your colleagues for more resources and past episodes, visit bjninform.com. Thank you so much for listening and see you next time.